March 26, 2024

Real Ear Measurement & Our Hearing Aid Fitting Process

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Real Ear Measurement & Our Hearing Aid Fitting Process

Real Ear Measurement (REM) is a cornerstone of our approach to accurately assessing and optimizing how a hearing aid functions in a user's ear. This objective measure allows us to see, in real time, how effectively a hearing aid amplifies sound within the ear canal, which is essential for tailoring the device to the individual's specific hearing needs.

Fitting Hearing Aids

As we fit hearing aids, our priority is to ensure that each device's settings are adjusted to provide the best possible hearing experience. By using REM, we can compare the actual output of sound from the hearing aid in the ear to the target amplification levels based on a patient's audiogram. This process helps us bridge the gap between the hearing aid's potential and its performance in a real-world setting, leading to higher satisfaction with the hearing aid fitting process.

We also recognize the significance of speech intelligibility in fitting hearing aids, which is why REM is invaluable. By simulating real-life listening environments, we can determine how well a patient will understand speech with their hearing aid. This gives us the information needed to fine-tune the hearing device, ensuring that it meets the wearer's needs in various listening situations and provides a marked improvement compared to standard factory settings.

Fundamentals of Sound

Sound Wave Physics

Sound is a traveling wave that is an oscillation of pressure transmitted through a solid, liquid, or gas. The properties of these sound waves can be broken down as follows:

  • Frequency: The number of times a wave cycles per second, measured in hertz (Hz). This determines the pitch of the sound.
  • Wavelength: The distance between identical points in the adjacent cycles of a waveform.
  • Amplitude: The peak value of a wave; in sound, this is perceived as volume and measured in decibels (dB).
  • Velocity: The speed at which a sound wave travels through a medium, influenced by the medium's density and temperature.

Sound waves are created by a vibrating object, which causes a series of compressions and rarefactions in the surrounding medium.

Human Hearing Mechanism

Our ability to hear hinges on a remarkable biological process that begins with the outer ear, which captures sound waves and funnels them to the eardrum. The key components include:

  • Outer Ear: Comprises the pinna and the ear canal, which direct sound waves towards the eardrum.
  • Middle Ear: Houses the ossicles (malleus, incus, stapes), tiny bones that amplify the vibrations from the eardrum.
  • Inner Ear: Contains the cochlea, a fluid-filled structure that translates these vibrations into electrical signals that the brain interprets as sound.

Each part of our auditory system is precisely tuned to process a wide range of frequencies and intensities, enabling us to perceive the rich tapestry of sounds that make up our acoustic environment.

Real Ear Measurement: An Overview

REM is the gold standard for hearing aid verification. Its purpose is to confirm that a hearing aid provides the correct levels of amplification for each wearer's unique hearing loss. By directly measuring the sound pressure level in the ear canal with the hearing aid in place, we can tailor the device's output to the individual's audiometric profile. This customization is essential because it leads to improved speech understanding, better hearing aid satisfaction, and overall enhanced communication ability.

Equipment and Technology Used

To perform REM, we use specialized equipment and technology:

  • Probe Microphone: A thin tube placed near the eardrum to pick up sound.
  • Signal Generator: Delivers sound through a loudspeaker into the ear canal.
  • Calibration Equipment: Ensures accurate readings by adjusting for the acoustic effects of the probe microphone and tubing.

Each component is integral to obtaining accurate measurements. Without proper calibration, for instance, the probe microphone could deliver misleading data, resulting in less effective hearing aid programming. Our meticulous approach guarantees that we leverage the full potential of the REM process for optimal hearing aid performance.

The Fitting Process

The fitting process involves a series of meticulous steps to ensure that hearing aids meet the unique needs of each user, encompassing assessment, personalization, and verification.

Assessment and Analysis

Prior to fitting hearing aids, we conduct a comprehensive assessment of the patient's hearing capabilities. This evaluation is critical as it informs us of the individual's specific hearing loss pattern, which is essential for tailoring the hearing aid settings.

  • Audiogram Creation: We create an audiogram to chart the patient's hearing sensitivity at different frequencies.
  • Hearing Loss Type Determination: Identifying the nature and degree of hearing loss allows us to select the appropriate hearing aid technology.

Personalization and Fitting

Understanding the patient’s hearing loss helps us in personalizing and fitting the hearing aids. This stage is where the real-ear measurement is paramount. It ensures the hearing aid's amplification is customized to the individual's ear canal acoustics.

  • Selection of Hearing Aid: Based on the assessment, a specific hearing aid style and technology level is chosen to best fit the patient's needs.
  • Physical Fit: We also focus on achieving a comfortable physical fit that complements the user's ear anatomy.

Verification and Fine-Tuning

The final stage is verification, where we confirm the hearing aid's effectiveness in providing the intended amplification. Real-ear measurements are conducted to verify sound levels in the ear canal, ensuring the patient experiences clarity, comfort, and maximum benefit from the hearing aid.

  • Real-Ear Measurements: Using a probe microphone, we measure sound levels in the ear canal to confirm that the hearing aid output matches target amplification levels.
  • Adjustments: Any necessary adjustments are made to optimize hearing aid performance based on the verification results.

Advancements in Sound Calibration

As we explore the realm of audiology, it's evident that calibration practices have become more refined, largely thanks to technological progress in the field.

Innovations in Real Ear Measurement

In recent years, we've seen significant advancements in Real Ear Measurement technology, allowing us to provide a more accurate and personalized hearing aid fitting. Modern REM systems have seen the integration of advanced software algorithms that streamline the process, enabling real-time analysis of the hearing aid's response within the ear canal. These systems have evolved to include features such as:

  • Automatic feedback detection to reduce measurement errors.
  • Integration with hearing aid fitting software for seamless adjustments.
  • Enhanced patient comfort with less invasive, more flexible probes.

Visit Us for Real Ear Measurement Verification

When selecting hearing aids, precision is key. We offer Real Ear Measurement as an essential part of our fitting process, ensuring your hearing aids are tailored to your unique hearing profile. At the Hearing Spa in Sarasota, FL, we ensure your hearing aids are not just fitted, but verified with precision. Schedule a consultation with us today.

Written by
Reviewed by
Dr. Victoria L. Moore
Lead Audiologist
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Dr. Victoria Moore (Vicky) serves as President as well as Lead Audiologist at The Hearing Spa. She moved to the USA from England in 1991 and has been serving the communities of Sarasota and Bradenton for over 20 years. Her independent audiology practice focuses on adult hearing loss, tinnitus management, as well as Cochlear Implant services.


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